Ovarian Pathology Notes

Question 1

What is adenomyoma?

Answer 1

A tumor of the uterus characterized by a mass of smooth muscle containing endometrial tissue and glands.

Question 2

What is adenomyosis? It’s found in how many cases of hysterectomies?

Answer 2

A benign invasive growth of endometrium into the myometrium.

Found in approximately 70% of hysterectomies.

Question 3

What is an arteriovenous fistula?

Answer 3

A vascular complex of arteries and veins without an intervening capillary system.

Question 4

What is Asherman syndrome?

Answer 4

Intrauterine adhesions ablating the endometrial lining.

Question 5

What is a Gartner duct cyst?

Answer 5

A small cyst within the vagina.

Question 6

What is hematocolpos?

Answer 6

Blood accumulation in the vagina.

Question 7

What is hematometra?

Answer 7

Blood accumulation in the uterus.

Question 8

What is hematometrocolpos?

Answer 8

Blood accumulation in the uterus and vagina.

Question 9

What is hyperplasia? (Endometrial)

Answer 9

Proliferation of the endometrial lining.

Question 10

What is an intramural leiomyoma?

Answer 10

A mass distorting the myometrium; most common location.

Question 11

What is a leiomyoma?

Answer 11

The most common benign gynecological tumor of the myometrium.

Question 12

What is Meigs syndrome?

Answer 12

A combination of pleural effusion, ascites, and an ovarian mass that resolves after surgery.

Question 13

What is a submucosal leiomyoma?

Answer 13

A mass distorting the endometrium; least common but most likely to cause symptoms.

Question 14

What is a subserosal leiomyoma?

Answer 14

A mass found on the serosal surface of the uterus.

Question 15

What is tamoxifen?

Answer 15

An antiestrogen medication used in treating breast cancer.

Question 16

What does the term ‘Tip of the Iceberg’ refer to?

Answer 16

A term used to describe the sonographic appearance of a dense ovarian dermoid tumor.

Question 17

What are the descriptive terms for pelvic pathology? 4

Answer 17

MASS CHARACTERISTIC DESCRIPTIVE TERMS include:
1. overall composition,
2. Internal characteristics
3. Wall definition
4. Doppler characteristics.

Question 18

What is the most common uterine neoplasm?

Answer 18

Intramural leiomyomas.

Question 19

What is carcinoma in the context of cervical pathology? How common is it in the US?

Answer 19

An epithelial neoplasm and the third most common gynecological malignancy in the United States.

Question 20

What are risk factors for cervical carcinoma? 5

Answer 20

1. Human papilloma virus (HPV)
2. Early sexual activity
3. Multiple sex partners
4. Use of oral contraceptives
5. Smoking.

Question 21

What are common clinical findings of cervical carcinoma? 5 (s/s)

Answer 21

1. Asymptomatic
2. Vaginal discharge or bleeding
3. Palpable mass
4. Weight loss
5. Intermenstrual or postcoital bleeding.

Question 22

What are sonographic findings of cervical carcinoma? 4

Answer 22

1. Hypoechoic or heterogeneous retrovesical mass
2. Irregular margins
3. Dilated ureter
4. Anechoic or hypoechoic endometrial fluid collection.

Question 23

What are differential considerations for cervical carcinoma? 6

Answer 23

1. Leiomyoma
2. Complex cervical cyst
3. Nabothian cyst
4. Obstructed inclusion cyst(s)
5. Chronic cervicitis.
6. Polyp

Question 24

What is adenomyosis?

Answer 24

Ectopic endometrial tissue within the myometrium.

Question 25

What are risk factors for adenomyosis? 3

Answer 25

1. Multiparity 2. Elevated estrogen levels 3. Aggressive curettage. (D+C)

Question 26

What are clinical findings of adenomyosis? 5 (s/s)

Answer 26

1. Asymptomatic 2. Pelvic pain or cramping 3. Uterine enlargement 4. Uterine tenderness 5. Menorrhagia.

Question 27

What are sonographic findings of adenomyosis? 4

Answer 27

1. Diffuse uterine enlargement 2. Smooth uterine contour 3. Heterogenous myometrium 4. Poorly defined anechoic areas within the myometrium.

Question 28

What is the appearance of a degenerating fibroid?

Answer 28

An endometrial neoplasm.

Question 29

What are the types of leiomyomas? 4

Answer 29

1. Intramural 2. Pedunculated 3. Submucosal 4. Subserosal.

Question 30

What is a leiomyosarcoma?

Answer 30

A rare tumor derived from the smooth muscle of the uterus.

Question 31

What are common symptoms of leiomyosarcoma?

Answer 31

Asymptomatic, vaginal bleeding.

Question 32

What are sonographic findings of leiomyosarcoma?

Answer 32

Heterogeneous uterine mass, irregular margins.

Question 33

What is endometrial carcinoma?

Answer 33

An abnormality associated with estrogen stimulation, with adenocarcinoma being the most common type.

Question 34

What are risk factors for endometrial carcinoma? 5

Answer 34

1. Obesity 2. Diabetes 3. Anovulatory cycles 4. Nulliparity 5. Postmenopause.

Question 35

What are clinical findings of endometrial carcinoma? 3 (S/S)

Answer 35

1. Abnormal bleeding 2. Focal irregularity of the endometrium 3. Myometrial distortion.

Question 36

What are differential considerations for endometrial carcinoma? 3

Answer 36

1. Endometrial hyperplasia 2. Endometrial polyp 3. Endometritis.

Question 37

What is a cystadenocarcinoma? What S/S does it present with? 3

Answer 37

An epithelial neoplasm presenting with a: 1. Palpable pelvic mass 2. Unexplained weight gain 3. Pelvic pain.

Question 38

What are sonographic findings of cystadenocarcinoma? 3

Answer 38

1. Multilocular 2. Complex mass with ill-defined wall margins 3. Mural nodules.

Question 39

What is another name for cystic teratoma? What does it arise from and contain? 3

Answer 39

1. Also called dermoid 2. It arises from the wall of a follicle 3. Contains fat, hair, skin, and teeth.

Question 40

What are clinical findings of a cystic teratoma? 3 (S/S)

Answer 40

1. Asymptomatic 2. Abdominal pressure 3. Mild to acute pelvic pain.

Question 41

What are sonographic findings of a cystic teratoma? 2

Answer 41

1. 'Tip of the Iceberg' appearance 2. Complex mass with thick, irregular margins.

Question 42

What is polycystic ovarian syndrome? What is it characterized by?

Answer 42

1. An endocrine imbalance causing chronic anovulation 2. Characterized by irregular menses and hirsutism.

Question 43

What are sonographic findings of polycystic ovarian syndrome?

Answer 43

Bilateral round, enlarged ovaries with presence of ten or more follicles per ovary.

Question 44

What is a Brenner tumor? What is it associated with?

Answer 44

A benign tumor arising from fibroepithelial tissue, associated with Meigs syndrome.

Question 45

What are clinical findings of a Brenner tumor? (S/S)

Answer 45

Asymptomatic, unilateral pelvic pain or fullness.

Question 46

What are sonographic findings of a Brenner tumor? 3

Answer 46

1. Small 2. Hypoechoic 3. Solid ovarian mass with well-defined wall margins.

Question 47

When is an arteriovenous fistula often diagnosed? What is it characterized by?

Answer 47

1. Often diagnosed post-abortion and postpartum 2. Characterized by multiple serpingous anechoic structures within the myometrium.

Question 48

What are clinical findings of an arteriovenous fistula? (S/S) 2

Answer 48

Menorrhagia, anemia.

Question 49

What are sonographic findings of an arteriovenous fistula? 3

Answer 49

1. Abundant blood flow within the anechoic structures 2. High-velocity 3. Low-resistance arterial flow.

Question 50

What is ovarian torsion?

Answer 50

Partial or complete rotation of the ovary on its pedicle, commonly associated with an adnexal mass.

Question 51

What are clinical findings of ovarian torsion? 3

Answer 51

1. Severe or consistent pelvic pain 2. Nausea/vomiting 3. Palpable pelvic mass.

Question 52

What are sonographic findings of ovarian torsion? 4

Answer 52

1. Decreased or absent venous and arterial blood flow to the ovary 2. Enlarged 3. Round 4. Heterogeneous ovarian mass.